AIM: To determine factors associated with fibrosis progression in hepatitis C virus (HCV)-infected patients without signifi cant initial pathological lesions. METHODS: Seventy six untreated HCV-infected pa-tients with...AIM: To determine factors associated with fibrosis progression in hepatitis C virus (HCV)-infected patients without signifi cant initial pathological lesions. METHODS: Seventy six untreated HCV-infected pa-tients with initially normal liver as defi ned by a Knodell score≤3,with 2 liver biopsies and detectable HCV-RNA were included. Markers of fibrosis progression were assessed. RESULTS: Median duration of infection and time between paired biopsies was 13 (95% CI: 1-28) and 4 (95% CI: 2-16) years respectively. Alanine-transaminase (ALT) activity was normal in 43.4% of cases. 50% demonstrated progression of the necro-in? ammation and 34% of fi brosis after a median time evolution of 4 years (95% CI: 2-16). The median dif-ference in the necro-inflammation and fibrosis score between biopsies was low,1.5 and 0.0 respectively. Univariate analysis showed there was no difference between fibrosis activity or evolution according to genotype or viral load. A higher fibrosis progression (P = 0.03) was observed in patients with body mass index (BMI) > 25. Fibrosis progression correlated with the time interval between biopsies (P = 0.01). A sig-nifi cant progression of activity (1.7 vs 0.4,P < 0.05) or fi brosis (0.9 vs 0.0,P < 0.01) was observed in patients with elevated ALT. There was a signifi cant correlation between activity progression and fi brosis progression (P = 0.003). Multivariate analysis demonstrated that fi brosis progression was associated with elevated ALT,BMI > 25 and the time interval between 2 biopsies. CONCLUSION: There is no fibrosis progression in 66% of patients without signifi cant initial histopatho-logical lesion. Fibrosis progression is associated with elevated ALT and BMI > 25.展开更多
文摘AIM: To determine factors associated with fibrosis progression in hepatitis C virus (HCV)-infected patients without signifi cant initial pathological lesions. METHODS: Seventy six untreated HCV-infected pa-tients with initially normal liver as defi ned by a Knodell score≤3,with 2 liver biopsies and detectable HCV-RNA were included. Markers of fibrosis progression were assessed. RESULTS: Median duration of infection and time between paired biopsies was 13 (95% CI: 1-28) and 4 (95% CI: 2-16) years respectively. Alanine-transaminase (ALT) activity was normal in 43.4% of cases. 50% demonstrated progression of the necro-in? ammation and 34% of fi brosis after a median time evolution of 4 years (95% CI: 2-16). The median dif-ference in the necro-inflammation and fibrosis score between biopsies was low,1.5 and 0.0 respectively. Univariate analysis showed there was no difference between fibrosis activity or evolution according to genotype or viral load. A higher fibrosis progression (P = 0.03) was observed in patients with body mass index (BMI) > 25. Fibrosis progression correlated with the time interval between biopsies (P = 0.01). A sig-nifi cant progression of activity (1.7 vs 0.4,P < 0.05) or fi brosis (0.9 vs 0.0,P < 0.01) was observed in patients with elevated ALT. There was a signifi cant correlation between activity progression and fi brosis progression (P = 0.003). Multivariate analysis demonstrated that fi brosis progression was associated with elevated ALT,BMI > 25 and the time interval between 2 biopsies. CONCLUSION: There is no fibrosis progression in 66% of patients without signifi cant initial histopatho-logical lesion. Fibrosis progression is associated with elevated ALT and BMI > 25.
